COMPARATIVE EFFECT OF SUB-OCCIPITAL MUSCLE INHIBITION TECHNIQUE AND MUSCLE ENERGY TECHNIQUE ON POSTERIOR CHAIN FLEXIBILITY IN YOUNG VOLLEYBALL PLAYERS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background:
Flexibility of the posterior chain plays a vital role in maintaining efficient movement, athletic performance, and
musculoskeletal health in volleyball players. The repetitive demands of volleyball, including jumping, landing,
sprinting, and sudden changes in direction, often lead to increased tension within the posterior myofascial
structures, resulting in reduced flexibility and a higher risk of sports-related injuries. Manual therapy techniques
such as the Sub-occipital Muscle Inhibition Technique (SMIT) and Muscle Energy Technique (MET) are frequently
used by physiotherapists to improve flexibility. Although both interventions have shown beneficial effects
individually, limited evidence is available comparing their influence on posterior chain flexibility in young
volleyball players.
Objective:
To compare the effectiveness of the Sub-occipital Muscle Inhibition Technique and Muscle Energy Technique in
improving posterior chain flexibility among young volleyball players.
Methods:
A randomized controlled trial was carried out on 60 volleyball players aged 15 to 25 years who demonstrated
reduced posterior chain flexibility. Participants were randomly assigned into two groups of 30 each. Group A
received the Sub-occipital Muscle Inhibition Technique, whereas Group B was treated with the Muscle Energy
Technique. Both groups underwent intervention five days per week for four weeks. Posterior chain flexibility was
evaluated using the Finger Floor Distance (FFD) Test, while hamstring flexibility was assessed with the Active
Knee Extension (AKE) Test. Statistical analysis was performed using paired and independent t-tests, with the level
of significance set at p < 0.05.
Results:
A significant improvement in flexibility was observed in both groups following the intervention period (p < 0.001).
Participants treated with the Sub-occipital Muscle Inhibition Technique demonstrated greater improvements in
Finger Floor Distance and Active Knee Extension scores compared with those who received the Muscle Energy
Technique. Although both treatment approaches were effective, the magnitude of improvement was higher in the
SMIT group, suggesting better enhancement of posterior chain mobility.
Conclusion:
Both the Sub-occipital Muscle Inhibition Technique and the Muscle Energy Technique are effective interventions
for improving posterior chain flexibility in young volleyball players. However, the findings of this study indicate
that the Sub-occipital Muscle Inhibition Technique provides greater improvement and may be considered a
preferable manual therapy approach for restoring posterior chain mobility, enhancing functional performance, and
supporting injury prevention in volleyball players